The surveillance tracks the type, amount and location of influenza that circulates at any given time. So far for this flu season, reports indicate 16 cases of the virus in Adams County and 72 in York County.

"This is what we would normally expect," said Ram Nambiar, director of the division of infectious disease epidemiology for the Pennsylvania Department of Health's bureau of epidemiology.

However, the data only includes influenza cases, found positive by rapid test, reported to the state department of health, which represents a fraction of actual illnesses across the state. That's because most people with flu symptoms do not get lab tests to identify influenza.

The state department of health estimates 600,000 to 1.2 million Pennsylvanians get the flu each year, including 200 to 2,000 who die from complications of influenza.

The flu is expected to peak in roughly three to four weeks, Nambiar said and added the best way to prevent influenza is to get a flu shot, which contains strains of the virus.

"It's not too late to vaccinate," he said.

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David D. Vega, medical director and chairman of emergency medicine for WellSpan York Hospital, agrees.

Vega said the flu is mainly spread through droplets from coughs and sneezes, which can allow the virus to travel about 6 feet.

"The flu virus may be spread for up to a day before symptoms start," he said via email.

Flu typically peaks in February, but may hit as late as March, Vega said.

"There is still time to get vaccinated," he said. "The flu vaccine cannot give you the flu but it may reduce or prevent the symptoms of the flu."

There are many points of entry to WellSpan for patients with flu-like symptoms, including the emergency department, physician offices, ReadyCare and Care Express, said York Hospital spokesman Barry Sparks via email.

"So, it's difficult to necessarily have a complete picture," he said of the number of flu cases.

Last year, February was the busiest month for the flu, Sparks said.

"We are just starting to see more cases of people with flu-like symptoms," he said.

"To date we have seen (one-third) the number of positive influenza patients that we had at this same time last year," Sparks said.

Michael Jhung, medical officer at Atlanta-based Centers For Disease Control's influenza division, said while the number of reported cases of influenza has grown across the country over the last week and is "widespread" in Pennsylvania, the virus is expected to spread.

"We haven't reached the peak of the flu season yet," he said. "Get vaccinated."